1. Differences and Similarities between Culture-Confirmed Human Granulocytic Anaplasmosis and Early Lyme Disease
- Author
-
Ira Schwartz, Harold W. Horowitz, Donna McKenna, Maria E. Aguero-Rosenfeld, Robert B. Nadelman, Dionysios Liveris, Lois Zentmaier, Susan Bittker, Mary E. Cox, Diane Holmgren, Denise Cooper, John Nowakowski, and Gary P. Wormser
- Subjects
Adult ,Male ,Microbiology (medical) ,Anaplasmosis ,Abdominal pain ,medicine.medical_specialty ,Human granulocytic anaplasmosis ,Diagnosis, Differential ,Lyme disease ,Internal medicine ,medicine ,Animals ,Humans ,Blood culture ,Prospective Studies ,Aged ,Lyme Disease ,Leukopenia ,biology ,medicine.diagnostic_test ,business.industry ,Bacteriology ,Middle Aged ,bacterial infections and mycoses ,medicine.disease ,biology.organism_classification ,Anaplasma phagocytophilum ,Blood ,Immunology ,Female ,Ixodes ,medicine.symptom ,business - Abstract
Lyme disease is transmitted by the bite of certain Ixodes ticks, which can also transmit Anaplasma phagocytophilum , the cause of human granulocytic anaplasmosis (HGA). Although culture can be used to identify patients infected with A. phagocytophilum and is the microbiologic gold standard, few studies have evaluated culture-confirmed patients with HGA. We conducted a prospective study in which blood culture was used to detect HGA infection in patients with a compatible clinical illness. Early Lyme disease was defined by the presence of erythema migrans. The epidemiologic, clinical, and laboratory features of 44 patients with culture-confirmed HGA were compared with those of a convenience sample of 62 patients with early Lyme disease. Coinfected patients were excluded. Patients with HGA had more symptoms ( P = 0.003) and had a higher body temperature on presentation ( P < 0.001) than patients with early Lyme disease. HGA patients were also more likely to have a headache, dizziness, myalgias, abdominal pain, anorexia, leukopenia, lymphopenia, thrombocytopenia, or elevated liver enzymes. A direct correlation between the number of symptoms and the duration of illness at time of presentation (rho = 0.389, P = 0.009) was observed for HGA patients but not for patients with Lyme disease. In conclusion, although there are overlapping features, culture-confirmed HGA is a more severe illness than early Lyme disease.
- Published
- 2013